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NPI Code Detail

MEDICARE: LAQUWANDA DANIELS

MEDICARE: LAQUWANDA DANIELS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner902602MS
2363L00000XNurse Practitioner902602MS
3363LC1500XCommunity Health Nurse Practitioner902602MS
4363LP2300XPrimary Care Nurse Practitioner902602MS
5363LG0600XGerontology Nurse Practitioner902602MS
6363LA2100XAcute Care Nurse Practitioner902602MS

General Provider Information

NPI Number : 1124703251
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAQUWANDA DANIELS
Provider Business Mailing Address
First Line : 9201 E MOUNTAIN VIEW RD STE 220
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-5172
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2500 N STATE ST
Second Line :
City : JACKSON
State : MS
Zip : 39216-4500
Country : US
Telephone Number : 601-984-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2023
Last Update Date : 06/15/2026

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1528993987 — ANNA MCDOWELL DMD
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1083249239 — BRADLEY K ALEXANDER MD
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Directions to “ LAQUWANDA DANIELS ” Practice Location

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